Free BCEN Certified Emergency Nurse (CEN) Practice Question

The correct answer is to administer fosphenytoin or phenytoin. This patient is in status epilepticus, defined as continuous seizure activity lasting more than 30 minutes or recurrent seizures without return to baseline. After initial treatment with benzodiazepines (in this case, lorazepam), the next step is to administer a long-acting antiepileptic drug, typically fosphenytoin or phenytoin. Propofol is used for refractory status epilepticus and would be considered if the seizures persist after antiepileptic drugs. While intubation may eventually be necessary, it's not the immediate next step. Phenobarbital is typically a third-line agent. CT scan, while important for identifying underlying causes, is not the immediate priority when actively seizing. The goal is to stop the seizure activity as quickly as possible to prevent neurological damage.